经胸心脏超声容量反应性评估在儿童重症监护室的应用

Volume responsiveness assessment by transthoracic echocardiography and the application in pediatric intensive care unit

液体复苏作为循环衰竭患者治疗的首要步骤，旨在提高心输出量，维持足够的组织循环灌注。根据 Frank-Starling 曲线原理，这一效应的前提是前负荷的增加在心功能所承受的范围内，而超负荷的液体输注将直接增加一部分患者的死亡风险。有效区分容量反应者或无反应者仍是成人和儿童重症监护医师面临的共同难题。近年来经胸心脏超声容量反应性评估成为本领域的研究热点，本文拟对相关研究成果及其在儿童重症监护室中的应用作一介绍。

Fluid resuscitation is the primary step in the management of acute circulation failure,aims to make a significant increase in cardiac output,and then providing adequate blood perfusion for peripheral tissues.According to Frank-Starling curve,the positive outcome only occurs in patients within a certain range of cardiac function,while in other conditions fluid overload would immediately increase the mortality. Distinguish-ing volume responders form non-responders effectively is still a serious problem common to adult and pediatric physicians at intensive care unit.Volume responsiveness assessment using transthoracic echocar-diography has become a research hotspot during the past few years,this review aims to make a summary of those findings as well as the present situation in pediatric field.